CPT code 92982 is used for coronary artery dilation, a procedure to widen narrowed or blocked coronary arteries to improve blood flow.
CPT code 92982 is used to describe the procedure of coronary artery dilation, commonly known as angioplasty. This procedure involves the widening of a narrowed or obstructed coronary artery, typically using a balloon catheter. The goal of coronary artery dilation is to improve blood flow to the heart muscle, alleviating symptoms such as chest pain and reducing the risk of heart attack. This code is essential for healthcare providers to accurately document and bill for the angioplasty procedure, ensuring proper reimbursement and maintaining efficient revenue cycle management.
For the CPT code 92982, which pertains to coronary artery dilation, the following modifiers may be applicable:
1. Modifier 26 - Professional Component: This modifier is used when the professional component of a service is being billed separately from the technical component. It is applicable if the physician is only providing the interpretation of the procedure.
2. Modifier 50 - Bilateral Procedure: This modifier is used if the procedure is performed on both sides of the body. In the context of coronary artery procedures, it would apply if the dilation is performed on both the left and right coronary arteries.
3. Modifier 51 - Multiple Procedures: This modifier is used when multiple procedures are performed during the same session. It indicates that the procedure is one of several performed on the same day.
4. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. It is used to prevent bundling of services that are typically considered part of a single procedure.
5. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when the same procedure is repeated by the same physician on the same day. It indicates that the procedure was necessary to be performed again.
6. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when the same procedure is repeated by a different physician on the same day. It indicates that the procedure was necessary to be performed again by another provider.
7. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: This modifier is used when a patient returns to the operating room for a related procedure during the postoperative period of the initial procedure.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when a procedure is performed during the postoperative period of another procedure, but it is unrelated to the original procedure.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
CPT code 92982 is associated with coronary artery dilation procedures. Whether this code is reimbursed by Medicare depends on several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the specific guidelines set by the Medicare Administrative Contractor (MAC) for the region where the service is provided.
As of the latest updates, CPT code 92982 is generally included in the MPFS, which means it is eligible for reimbursement under Medicare, provided that the service is deemed medically necessary and is performed in accordance with Medicare's coverage policies. However, the actual reimbursement can vary based on the locality and specific MAC policies, as each MAC has the authority to interpret national Medicare policies and set local coverage determinations (LCDs) that may affect reimbursement.
Healthcare providers should verify the current status of CPT code 92982 with their local MAC to ensure compliance with any specific documentation or billing requirements that may impact reimbursement. Additionally, staying updated with any changes in the MPFS is crucial, as these can affect the reimbursement rates and coverage status of specific CPT codes.
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